This is the renewal application for Years 6-10 of a training program designed to produce investigators at the cutting edge of research in the area of adult gastroenterology. Trainees are at the postdoctoral level and a mixture of MDs and PhDs supported for 2 years for a total request of 3 stipends/yr. For all trainees, the program has placed strong emphasis on epidemiology and health services research, the rationale being the critical need for bench to bedside translational research. There is also a need for bedside to clinic, or efficacy to effectiveness, and patient centered comparative effectiveness translational or outcomes research. The mentors (2 MDs, 6 MD/MPH, 1 MD/PhD and 1 PhD) represent a multidisciplinary group of experienced investigators from various departments at Baylor College of Medicine (BCM) and the University of Texas Health Science Center. Their research covers broad areas of clinical research including epidemiology (including clinical, molecular, genetic, and microbiome), health services research, decision making, and implementation research related to several digestive disorders. All mentors research groups are well funded. Existing faculty members have outstanding mentoring histories, and excellent track records of interaction and participation in our training program activities. The Program Director, Hashem B El-Serag, MD, MPH, maintains ultimate authority for the program and manages day-to-day operations. He is assisted by an Associate Program Director (Thomas Giordano, MD, MPH). The leadership remains stable since the start of the training program. Major administrative decisions (e.g., selection of trainees) are handled by a selection Committee, which includes the Program Director, Associate Director, and three other program faculty. The trainees have individual research mentoring committees, must prepare a written research proposal to be defended to the research committee, and have periodic reviews that include academic and career assessment. Trainees are required to attend a weekly research seminar series and a monthly journal club. All trainees must present at these meetings. Trainees are selected from a highly competitive applicant pool that already exists at BCM. Over the past 4 years, admission into the program has been very competitive, and all available were filled with high quality candidates. The trainees have performed well with the first two post-doctoral graduates obtaining Masters degrees in Public Health, remaining in academia, and each has several first author original research papers published in high impact journals and several national research presentations. The current proposal includes several new features designed to enrich and enhance the existing program including new mentors, thrice yearly scientific social combined with the pediatric GI training program and a two year Clinical Scientist Training Program for MD trainees.